Sunday, 27 June 2010

The Director of Public Prosecutions (DPP), Keir Starmer, whose job it is to prosecute people who break the law, announced last Friday that he did not consider it to be in the public interest to bring a case against former GP Michael Irwin (pictured), for assisting the suicide of pancreatic cancer sufferer Ray Cutkelvin in 2006.

It was not that he lacked evidence to do so. Irwin had literally begged the DPP to put him away so that he could become a martyr for the pro-euthanasia movement. He had even provided documentary evidence of his involvement in terms of a £1,500 payment towards paying for Cutkelvin's visit to the Dignitas Suicide facility in Zurich.

In fact, Irwin, previously chairman of the Voluntary Euthanasia Society (now euphemistically rebranded Dignity in Dying) has helped no less than nine people kill themselves, and had even been struck off by the General Medical Council in 2005 for a past attempt.

But nonetheless, the DPP judged that although he had clearly done the deed, it was not in the public interest to make him stand trial.

His justification for this was that Irwin’s case did not fulfil enough of the 22 ‘prosecution criteria’ that he had made public at the request of the Supreme Court ruling on the case of Debbie Purdy last July.

Assisted suicide remains illegal in Britain and still carries a custodial sentence of up to 14 years for convicted offenders. But of over 130 British citizens who have so far travelled to Switzerland to be helped to kill themselves, none have even been tried, let alone convicted.

And the three most recent cases (Downes, Bateman and Rees) have all been let off on the grounds that they were ‘wholly motivated by compassion’ – a mitigating factor seemingly open to liberal interpretation and not easily testable in court (especially given that the key witness in all cases is dead and unable to give evidence).

It appears a pattern is emerging. The police seem reluctant to investigate. The DPP looks to be unwilling to prosecute. Juries are reticent to convict and judges, for those very few cases that do reach this stage, are giving light sentences.

This sort of ‘legal sanction’ is exactly what first happened in the Netherlands and led eventually to an eventual change in the law in that country - legalisation by stealth.

Holland now reports over 1,000 cases of involuntary euthanasia a year, an annual increase in cases of voluntary euthanasia and dozens of disabled children being ‘put down’ under the so-called Groningen protocol.

No wonder that disability rights leaders in this country have just launched a Resistance Campaign asking MPs to sign a charter supporting better care and services for elderly and disabled people and no change in the law.

So far Parliament has stood firm, as have professional groups like the British Medical Association, believing that any change in the law would be a threat to public safety.

One wonders however what it will take for the DPP, the very person appointed to uphold the law, actually to prosecute someone. If he wants the current law to act as an effective deterrent against abuse he will at some point have to be willing to show some teeth.

But the impression he has given with this latest judgement, is that any would-be assisters may go at least as far as Dr Irwin has thus far, without any fear of legal repercussion.

‘A fisherman once told me that fish have neither sense nor sensation, but how he knew this he could not tell me’(Bertrand Russell)

In a House of Lords debate on abortion in November 2007, Lord Clarke, commented, ‘I do not know whether fish feel pain or not, but (Bertrand) Russell's point was that we should be very wary of drawing our conclusions on this matter solely from those who have a vested interest in the fishing industry. The 6.7 million abortions carried out in this country since 1967 have been performed by doctors; most of whom are members of the Royal College of Obstetricians and Gynaecologists and many of them benefit financially from the process. Might this be a subtle way of influencing their interpretation of the data? Would we not be wary about seeking opinions about the link between smoking and lung cancer only from employees in the tobacco industry?’

It will come as no surprise to many that the RCOG, whose members carry out virtually all Britain’s late abortions, has just concluded in a new report that babies at 18-24 weeks gestation are in a continual state of sleep and lack the neurological apparatus necessary to feel pain. How very convenient. Not that many will see it as relevant to the debate at all. Is it any less wrong, they will ask, to take someone’s life when they are anaesthetized or sleeping, than when they are awake?

But regardless of what view we might take on that, mothers feeling their babies kicking at 16-20 weeks, and indeed all parents who have witnessed their progeny on a routine 18 week scan, sucking their thumbs, scratching their noses or yawning, will intuitively feel unsettled by this new report – and rightly so.

We know that babies at this gestation react to noxious stimuli in the same way that you or I would, by reflex withdrawal and stress hormone secretion. Of course this does not necessarily prove that they are feeling pain in the same way; but one might reasonably feel that they should at least be given the benefit of any doubt. Not so says the RCOG.

The two researchers the RCOG wheel out whenever they are challenged on this issue, Maria Fitzgerald and Stuart Derbyshire, argue as follows: ‘Pain sensation requires neural pain pathways reaching the cerebral cortex. This doesn’t happen until 24 weeks gestation. Therefore pain cannot be felt until then.’

This sounds logical enough, but is it really that simple? Are these neural connections really necessary in order for pain to be felt at all? Not all experts agree. As the report acknowledges in its small print (but noticeably not in its loudly trumpeted conclusions) there is a significant body of expert opinion that does not concur with the idea that pain sensation requires higher cortical connections. These other experts, as actually acknowledged in the body of the report, express ‘disquiet in denying a rawer, more primitive, form of pain or suffering that the fetus, neonate and many animals might experience’.

The references in the paper are to the work of none other than leading fetal pain authority Professor KJS (Sunny) Anand, from the University of Arkansas, whose evidence to the House of Commons Science and Technology Committee was similarly marginalized and ignored in 2007, as highlighted in a highly publicized minority report written by two of its MP members.

But you will not learn any of this detail from the BBC and most newspapers. The general public is rather being sold the lie that there is no doubt about this at all. Nor will you learn, other than from the small print in the report itself, that the ‘evidence’ that the fetus is ‘asleep’ in the womb comes from studies in sheep rather than in humans. Professor Stuart Campbell, the UK’s leading authority on 4D fetal ultrasound, who has opened up the intricacies of life in the womb and could have shed light on the matter, was, like Anand, not consulted by the RCOG. No dissenting expert voices it appears were given any platform. The message and conclusions had to be clear and simple, unclouded by any nuance or uncertainty.

And so we have the RCOG once again cherry picking experts guaranteed to deliver convenient conclusions, and then selectively reporting them to a gullible media and public, in order to justify its historic position that babies killed by late abortion do not require pain relief and are by implication, not really sentient human beings worthy of any respect.

Sunday, 20 June 2010

Last month’s election threw up some interesting results as a variety of issues took prominence in different constituencies.

In particular we saw strong reactions to four conservative parliamentary candidates who had, either during the campaign or previously, held views which were judged as being ‘homophobic’.

Philip Lardner lost his candidacy for saying that homosexuality was 'not normal behaviour' – sacked by party leader David Cameron. The uproar surrounding Philippa Stroud’s Christian beliefs about the issue was a major factor in her failing to take Sutton and Cheam for the Tories. Chris Grayling’s comments about Christians offering ‘bed and breakfast’ being justified in denying double beds to gay couples staying in their homes almost certainly cost him a cabinet post.

Theresa May managed to hold on as Equality Minister after the election, despite over 70,000 people joining a Facebook group asking for her to be sacked on the basis of her past ‘homophobic’ voting record, when she said her views on homosexuality had now changed.

Being judged ‘homophobic’ can cost you dearly.

I’ve always been puzzled by the term ‘homophobia’. In the minds of most people it means being prejudiced against, or even hating, people who are homosexual.

Wikipedia defines it as ‘a range of negative attitudes and feelings towards homosexuality and people identified or perceived as being homosexual’.

In keeping with this view, author, activist, and civil rights leader Coretta Scott King in a 1998 address, equated homophobia to ‘racism and anti-Semitism and other forms of bigotry’ on the grounds that ‘it seeks to dehumanize a large group of people, to deny their humanity, their dignity and personhood’.

It is therefore understandable that 'homophobic' is a label that no one wants to have.

However when the term was first used it actually meant something quite different.

The word homophobia first appeared in print in an article written for the 23 May 1969 edition of the American tabloid Screw, in which it was used to refer to heterosexual men's fear that others might think they are gay. It has also been used to describe a fear of people who ‘come out’ as homosexual.

These definitions are much more in keeping with the literal meaning. After all, a phobia is a fear: claustrophobia, arachnophobia and acrophobia being fears of closed spaces, spiders and heights respectively.

For many people 'homophobia' is actually about ‘having a fear of being accused of being bigoted, prejudiced or discriminating against homosexual people’.

This fear, which is increasingly common, causes people to take a defensive posture in order to avoid attracting disapproval or adverse publicity. This may take the form of changing ones public position, pretending to adopt views in accordance with the prevailing liberal consensus, actively denying ones real beliefs or simply abstaining from expressing an opinion when the matter is discussed.

This kind of ‘homophobia’ is becoming increasingly common amongst those who belong to religious faiths which teach that sex outside marriage is wrong (ie. most world faiths) and it is not difficult to come up with examples of (often) prominent people in whom the condition is well advanced.

For people who don’t hate, dislike or fear gay people, but simply believe that sex between people who are not married (including all sex between those of the same sex) is morally wrong, we need a new term.

I’d like to propose the term ‘homosceptic’ - a term that is not yet in common use and hence arguably open to (re)definition. My Microsoft Word spell-check rejects it as an unknown word and a Google search for it throws up only 1,830 examples of its use in any context.

The Urban dictionary defines a 'homosceptic' as ‘a member of society who does not hate homosexuals, but generally does not agree with the principle of homosexuality in moral and ethical terms’.

I’d like to broaden this definition to include ‘being sceptical about the key presuppositions of the gay rights movement’ such as the beliefs that:

• Homosexuality is genetically determined • Homosexual orientation is always fixed • Sexual orientation is a biological characteristic like race, sex or skin colour• Feelings of same sex attraction should be welcomed and acted upon• Offering help to those who wish to resist or eradicate these feelings is always wrong

Of course if you accept these ‘key presuppositions’ you may well believe people who don’t to be ignorant, bigoted, prejudiced or even immoral. You might even feel that such people should not hold public office, publicly express their views or hold any job which involves having to condone, promote or facilitate same-sex intimacy.

But if you have some doubts about the truth of some or all of these beliefs – and suspect that they might be more ‘ideology-driven’ than ‘evidence-based’ – then perhaps you could argue that you are not ‘homophobic’ but rather ‘homosceptic’.

Saturday, 19 June 2010

Dr Howard Martin, a now retired Co Durham MP, was struck off on Friday by the General Medical Council (GMC) for giving excessive morphine doses to 18 dying patients.

He has since admitted, in an interview with the Daily Telegraph that he deliberately hastened the deaths of patients in his care, some without their consent, and that he acted out of ‘Christian compassion’ in doing so.

As he was cleared five years of three murder charges, on grounds that it could not be proved either that the morphine had killed the patients or that he intended their deaths, the question has now been raised whether he should be tried again.

Under the 2003 Criminal Justice Act, which removed the defence of ‘double jeopardy’, it is now possible for a person to be tried twice for the same crime if new evidence warrants it. The coroner is to review the cases and the Crown Prosecution Service will then have to make a decision about whether to prosecute.

The GMC ruled that Martin ‘violated the rights of the terminally ill’ and that some of his actions had been both ‘dangerous and despicable’. They added that his treatment of some patients had been ‘completely unacceptable’ and that he had acted on the ‘scantiest of evidence’ of unbearable pain. His actions were ‘indicative of an autocratic attitude, in that he seemed always to consider that he was right and rejected, or did not seek, the views of others’.

Someone who deliberately gives overdoses of morphine to patients with the intention of hastening their deaths, refuses to consult other doctors when he finds himself beyond his level of competence, and then lies to the police about what he has done, is not demonstrating ‘Christian compassion’.

True compassion means pulling out all the stops to provide the best possible care to ease patients’ distress whilst staying within ethical boundaries.

It is also simply not necessary to kill the patient in order to kill the pain. It is therefore essential that doctors who find themselves beyond their depth in managing patients with distressing symptoms, should seek advice from specialists in palliative medicine, rather than leaving people with substandard care or, even worse, taking the matter into their own hands.

This case underlines the need for better education about what palliative care can achieve, and better training in palliative medicine for all front line doctors, in order that all patients benefit from the very best care already available in this country.

We will, without doubt, now hear further calls from the pro-euthanasia lobby to change the law to allow doctors in some circumstances to end the lives of some patients on ‘compassionate grounds’. But this would be both dangerous and unnecessary.

The current law, which gives a blanket ban on all so-called ‘mercy killing’ is clear and right and is essential to ensure that the lives of vulnerable people are not exploited or abused. It provides a strong deterrent to abuse through the penalties that it holds in reserve, whilst allowing discretion to both prosecutors and judges to temper justice with mercy in hard cases. It does not need changing.

This tragic case illustrates rather that some doctors can act irresponsibly, incompetently and unethically and yet still claim, and apparently sincerely believe, that they have done nothing wrong, or even worse, that they have acted compassionately. Changing the law to allow any form of compassionate killing would not confer any sort of ‘right to die’. It would rather give doctors the authority and power to kill and provide some with an excuse for what is in reality incompetence, laziness or the unwillingness to seek help.

Recent reports from the Netherlands (showing a further rise in euthanasia cases last year) and Belgium (showing that nurses are now killing patients without their consent) demonstrate how, when euthanasia is legalised for any reason, any so-called ‘safeguards’ will inevitably be abused.’

Sunday, 13 June 2010

I was quoted on the front page of the Sunday Telegraph this morning in an article reporting that 89 teenage girls aged 17 or under had had their third abortion last year.

The article is accompanied by a strong editorial criticising government sex education policies and suggesting that we should actually be advocating sexual abstinence for teenagers as a way of dealing with what is now an unplanned teenage pregnancy epidemic.

As the article reports, the 2009 abortion statistics show that for the first time over a third (34%) of all abortions were performed on women who had already ended one or more previous pregnancies, that over 1,000 women who had abortions last year were on their fifth at least and almost 50 on their eighth or beyond.

What the Telegraph doesn’t tell you is that we are being denied information about the true level of the problem because the Department of Health has deliberately chosen to suppress information about the numbers of repeat abortions in teenagers (see the gaps in table 4b on page 13 of the report), presumably to avoid further criticism of its failed teenage pregnancy strategy. How many younger teenagers (or 18 to 24 year olds) were on their fourth, fifth, sixth, seventh or eighth abortion? We do not know because we are not being told.

It is increasingly clear that abortion is simply being used as a form of contraception by a growing percentage of women and that the government's tired policy of values-free sex education, condoms and morning after pills is not working in stemming the flow. Given the growing evidence of a link between past abortion and subsequent depression or premature birth (the severity of the latter being directly linked to the number of past abortions) it is clear that this is resulting in a legacy of mental and physical health problems for British women.

It is also profoundly ironic that 97% of abortions are being performed on spurious mental health grounds when there is in fact very little evidence to suggest that continuing with an unplanned pregnancy poses greater risk to a mother's mental health than having an abortion. In fact there is growing evidence to suggest that the very opposite is true.

After over seven million abortions in Britain, 94% of which are now funded by taxpayers' money, the new coalition government has a responsibility to come clean and admit that past strategies have failed to deliver. It is time to appoint better advisors and to have a radical rethink about strategies aimed at curbing promiscuity and its legacy of sexually transmitted disease, unplanned pregnancy and abortion.

There are ethnic, religious and cultural communities within the UK whose rates of unplanned pregnancy, sexually transmitted disease and abortion rates are considerably below the national average. If the new coalition government is really serious about addressing the problems of Britain's so-called broken society, then it should perhaps commission some serious research and seek their advice.

The current policy, by contrast, is based on two false presuppositions – that contraceptives are foolproof and that abstinence is impossible. Neither is true. The best ‘oral’ contraceptive is a word of one syllable – ‘no!’ It would be a refreshing change to see a public policy approach that includes teaching girls how to say it more often and teaching boys to respect it.

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Kiwi, Christian and Medical

This blog deals mainly with matters at the interface of Christianity and Medicine. But I do also diverge into other subjects - especially New Zealand, rugby, economics, developing world, politics and topics of general Christian and/or medical interest. The opinions expressed here are mine and may not necessarily reflect the views of my employer or anyone else associated with me.

About Me

I am CEO of Christian Medical Fellowship, a UK-based organisation with 4,500 UK doctors and 1,000 medical students as members. The opinions expressed here however are mine, and may not necessarily reflect the views of CMF or anyone else associated with me.